The google forms based commenting that Mat made for twaddle 
<>, which is probably what 
you are talking about with the comment icon on well made wikis, is done by 
storing comments on google sheets using the google forms api. This is 
sharing the information with google. And you can't use facebook to track or 
limit who access the data without sharing the identity data with facebook. 
I used hashover on my blog wiki thing 
<>, but that requires my own 
hosting space and I wouldn't put too much faith in how secure it is.

You can make a general information wiki that is generally accessible to 
anyone online and they can download their own copy and enter whatever 
information they want into it. It would be on their own device and they 
would have full control of it, but it would only be on that device and they 
couldn't access it from elsewhere unless they hosted it themselves. And in 
this case you would still have to have some server-side mechanism to see 
who accessed it and to have any sort of authentication. If you intend to 
provide the hosting for the users private wikis than the authentication to 
be able to access and edit these wikis would need to come from something 
other than tiddlywiki, or we would need to create tools to do that which 
would be a rather large task by itself.

It sounds like you may just want to use tiddlywiki as a frontend to 
whatever service will be used to access the EHR data. That is something 
tiddlywiki could be used for but there are many other pieces that would 
need to be created. I am not sure that tiddlywiki is an appropriate tool 
for what you want to do.

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